Service-Learning in Medical Anthropology

In the academy, we often bemoan the fragility of millennial college students — this generation whose protective parents insulate them from the risk of failure (for instance, see this 2012 Chronicle of Higher Education article). How, such discourses often ask, do we snap students out of their protective bubbles? Service-learning can challenge students to step outside their comfort zones, put methods into practice, and step up to take an active role in their educational experience.

To create an effective service-learning course requires significant legwork, and I learned how to do much of this through participation in the 2015-16 Faculty Fellows in Service Learning program. In spring 2017, as a follow-up to that fellowship, I taught an undergraduate course called Mental Health in Global Perspective. It is a critical survey of psychological anthropology, transcultural psychiatry, and global mental health literature, and this time I added a service-learning component. The course met once a week to discuss 4-6 articles or book chapters arranged around key themes. During the rest of the week, students spent a 3-hour block conducting observations at the psychiatric and geriatric teaching clinics at the University’s College of Community Health Sciences. The college, which is transitioning to a more holistic model of patient care, requested that we provide a final presentation to faculty and residents on the connections between our cross-cultural readings on mental health and our clinical observations. The presentation comprised part of a lecture series for medical residents and served as the course’s final project. Although we felt we gained more than we gave, we were excited to contribute to the educational goals of the college by introducing residents and faculty to the holistic approach of medical anthropology. This was the “service” component of service-learning, and what distinguished it from a standard experiential learning project.

Service-learning benefits students by integrating collaboration and project-based learning into the curriculum. My students were particularly enthusiastic about putting anthropological fieldwork skills into practice. A senior commented, “As undergraduate students, we often learn about the methods used by experienced anthropologists and read ethnographies detailing fascinating research, but rarely are we presented with the ability to perform our own fieldwork.” Most had some background in anthropology, and with brief instruction about how to take, code, and analyze field notes, they jumped into the project. Compared to a prior year when I taught this course without a service-learning component, students were significantly more engaged. They came away with anthropological fieldwork experience that was significant enough to warrant a place on a resume, and several who were applying to graduate programs or anthropology-related jobs found this additional qualification immediately useful.

Students made connections between the observational component of the course and their personal lives. Many students’ initial interest in the course was also personal — they or someone they knew had experienced mental health problems. Students’ observations reflected these connections. Some felt worried after seeing how physicians talk about patients behind the scenes. “I realized that the physicians themselves are people with the need to decompress and joke about patients in order to keep going,” noted one student with bipolar disorder. “Some of this was lighthearted and harmless, but some of it felt targeted and personal. Character flaws were pointed out to residents — almost as if they needed to be warned or prepped prior to the interaction. I sat there thinking, ‘What flaws do the doctors point out on me?’”

Others, however, felt that their insights into the inner workings of a psychiatric clinic allowed them to take more control of their own care. “I found that conducting observations in the clinic trained me to be a better patient. Knowing what goes on behind the scenes has allowed me to get the most out of my own doctor visits by identifying how my symptom pool is perceived ahead of time and researching the medications the doctor is most likely to suggest to me,” said another. Positive or negative, the fact that students made these connections between their personal lives and the coursework suggested they were reaching a goal all instructors hope to achieve — relevance outside the classroom.

This service-learning course also challenged students to create practical, interdisciplinary communication between anthropology and biomedicine. We read extensively about collaboration between anthropology and public health but struggling to accomplish this brought the dilemma into sharp relief for my students. Because they were responsible for producing a final presentation that was faithful to their observations but also respectful of our hosts, students had to think hard about how to present our more critical observations in a constructive manner. A sophomore commented, “I’ll admit that I didn’t go into this experience with the most open of minds. I’m aware of my bias being pro-alternative health and that I tend to see medicine as a business. I was pleasantly surprised to learn that the Health Center makes a strong, concerted effort to promote an interdisciplinary practice of medicine.” In order to report on medical providers’ behavior in a constructive manner, students ultimately had to learn to apply cultural relativism toward the practitioners they observed. This is something often lacking in medical anthropology courses, which critique biomedicine but may not devote much class time to generating constructive solutions.

I’ll close with the words of a student whose reflections convey everything we wish to instill in our undergraduate majors: “As (hopefully) future anthropologists, we have gained so much from this project. We learned how to apply theory, how to be ethnographers, and how to translate our message to the public. For me, this project was inspirational because it allowed me to imagine myself as a medical anthropologist. It gave me insight into the challenges I would have to face and visions of what I could do to change the field of study.” I could not have hoped for more.

Lesley Jo Weaver is an assistant professor in the Department of Anthropology and an affiliated faculty member in UA’s Asian Studies program.